BACKGROUNDMedical thoracoscopy is a minimally invasive procedure that allows access to the pleural space using a combination of viewing and working instruments. The main diagnostic and therapeutic indications for Medical Thoracoscopy are difficult pleural effusions, empyemas and pneumothorax. It can also be effectively used in the diagnosis and management of early stages empyema.
BACKGROUNDSleep is a highly organized, complex behaviour characterized by a relative disengagement from the outer world and variable, but specific brain activity. It is an endogenously generated, homeostatically regulated and reversible. During sleep, there are profound physiological changes. This is particularly true of breathing and in number of conditions this had important implications. Breathing alters according to the state of consciousness. In healthy subjects, ventilation falls with the onset of sleep and is reduced during all phases of sleep compared with waking levels, alterations in the pattern of breathing occur including periodic breathing, apnoea, hypopnoea with gradual progression from stage I, II (18% decreased) to REM sleep (35% of decrease ventilation to awake stage). REM sleep related alterations in ventilation is more severe in respiratory disordered patients who had already some Hypoxemia, COPD is of best example.
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